Elevated global cerebral blood flow, oxygen extraction fraction and unchanged metabolic rate of oxygen in young adults with end-stage renal disease: an MRI study

Gang Zheng, Jiqiu Wen, Hanzhang Lu, Yaxian Lou, Zhiying Pan, Wei Liu, Hui Liu, Xue Li, Zhe Zhang, Huijuan Chen, Xiang Kong, Song Luo, Xiaolu Jiang, Ya Liu, Zongjun Zhang, Long Jiang Zhang, Guang Ming Lu

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objectives: To noninvasively assess global cerebral blood flow (CBF), oxygen extraction fraction (OEF) and cerebral metabolic rate of oxygen (CMRO<inf>2</inf>) in young adults with end-stage renal disease (ESRD). Methods: Thirty-six patients and 38 healthy volunteers were included and took part in MR examinations, blood and neuropsychological tests. CBF and OEF were measured by phase-contrast and T2-relaxation-under-spin-tagging MRI techniques, respectively. CMRO<inf>2</inf> was computed from CBF, OEF and hematocrit according to Fick’s principle. Correlations were performed between MR measurements, blood biochemistry measurements and neuropsychological test scores. Results: Compared with controls, ESRD patients had elevated CBF (72.9 ± 12.5 vs. 63.8 ± 8.5 ml min<sup>−1</sup> 100 g<sup>−1</sup>, P < 0.001), elevated OEF (47.2 ± 10.2 vs. 35.8 ± 5.4 %, P < 0.001), but unaffected CMRO<inf>2</inf> (199.5 ± 36.4 vs. 193.8 ± 28.6 μmol O<inf>2</inf> min<sup>−1</sup> 100 g<sup>−1</sup>, P = 0.879). Hematocrit negatively correlated with CBF (r = −0.640, P < 0.001) and OEF (r = −0.701, P < 0.001), but not with CMRO<inf>2</inf>. Altered neuropsychological test scores of ESRD patients were associated with OEF and CBF, but not with CMRO<inf>2</inf>. There were weak relationships between eGFR and hematocrit (r = 0.308, P = 0.068) or CBF (r = 0.318, P = 0.059). Conclusion: Our findings suggested that anaemic young adults with ESRD may afford higher CBF and OEF to maintain a normal CMRO<inf>2</inf>. Despite this compensatory process, however, cognitive function was still impaired and its severity was correlated with their CBF and OEF abnormality. Key Points: • Anaemic young adults with ESRD may afford higher CBF and OEF.• Anaemic young adults with ESRD maintain a normal CMRO<inf>2</inf>.• Cognitive function was still impaired in young ESRD adults.• The severity of cognitive dysfunction correlated with CBF and OEF changes.

Original languageEnglish (US)
JournalEuropean Radiology
DOIs
StateAccepted/In press - Sep 3 2015

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Cerebrovascular Circulation
Chronic Kidney Failure
Young Adult
Oxygen
Neuropsychological Tests
Hematocrit
Cognition
Hematologic Tests
Biochemistry

Keywords

  • Cerebral blood flow
  • Cerebral metabolic rate of oxygen
  • End-stage renal disease
  • Oxygen extract fraction
  • Uremic encephalopathy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Elevated global cerebral blood flow, oxygen extraction fraction and unchanged metabolic rate of oxygen in young adults with end-stage renal disease : an MRI study. / Zheng, Gang; Wen, Jiqiu; Lu, Hanzhang; Lou, Yaxian; Pan, Zhiying; Liu, Wei; Liu, Hui; Li, Xue; Zhang, Zhe; Chen, Huijuan; Kong, Xiang; Luo, Song; Jiang, Xiaolu; Liu, Ya; Zhang, Zongjun; Zhang, Long Jiang; Lu, Guang Ming.

In: European Radiology, 03.09.2015.

Research output: Contribution to journalArticle

Zheng, G, Wen, J, Lu, H, Lou, Y, Pan, Z, Liu, W, Liu, H, Li, X, Zhang, Z, Chen, H, Kong, X, Luo, S, Jiang, X, Liu, Y, Zhang, Z, Zhang, LJ & Lu, GM 2015, 'Elevated global cerebral blood flow, oxygen extraction fraction and unchanged metabolic rate of oxygen in young adults with end-stage renal disease: an MRI study', European Radiology. https://doi.org/10.1007/s00330-015-3968-9
Zheng, Gang ; Wen, Jiqiu ; Lu, Hanzhang ; Lou, Yaxian ; Pan, Zhiying ; Liu, Wei ; Liu, Hui ; Li, Xue ; Zhang, Zhe ; Chen, Huijuan ; Kong, Xiang ; Luo, Song ; Jiang, Xiaolu ; Liu, Ya ; Zhang, Zongjun ; Zhang, Long Jiang ; Lu, Guang Ming. / Elevated global cerebral blood flow, oxygen extraction fraction and unchanged metabolic rate of oxygen in young adults with end-stage renal disease : an MRI study. In: European Radiology. 2015.
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abstract = "Objectives: To noninvasively assess global cerebral blood flow (CBF), oxygen extraction fraction (OEF) and cerebral metabolic rate of oxygen (CMRO2) in young adults with end-stage renal disease (ESRD). Methods: Thirty-six patients and 38 healthy volunteers were included and took part in MR examinations, blood and neuropsychological tests. CBF and OEF were measured by phase-contrast and T2-relaxation-under-spin-tagging MRI techniques, respectively. CMRO2 was computed from CBF, OEF and hematocrit according to Fick’s principle. Correlations were performed between MR measurements, blood biochemistry measurements and neuropsychological test scores. Results: Compared with controls, ESRD patients had elevated CBF (72.9 ± 12.5 vs. 63.8 ± 8.5 ml min−1 100 g−1, P < 0.001), elevated OEF (47.2 ± 10.2 vs. 35.8 ± 5.4 {\%}, P < 0.001), but unaffected CMRO2 (199.5 ± 36.4 vs. 193.8 ± 28.6 μmol O2 min−1 100 g−1, P = 0.879). Hematocrit negatively correlated with CBF (r = −0.640, P < 0.001) and OEF (r = −0.701, P < 0.001), but not with CMRO2. Altered neuropsychological test scores of ESRD patients were associated with OEF and CBF, but not with CMRO2. There were weak relationships between eGFR and hematocrit (r = 0.308, P = 0.068) or CBF (r = 0.318, P = 0.059). Conclusion: Our findings suggested that anaemic young adults with ESRD may afford higher CBF and OEF to maintain a normal CMRO2. Despite this compensatory process, however, cognitive function was still impaired and its severity was correlated with their CBF and OEF abnormality. Key Points: • Anaemic young adults with ESRD may afford higher CBF and OEF.• Anaemic young adults with ESRD maintain a normal CMRO2.• Cognitive function was still impaired in young ESRD adults.• The severity of cognitive dysfunction correlated with CBF and OEF changes.",
keywords = "Cerebral blood flow, Cerebral metabolic rate of oxygen, End-stage renal disease, Oxygen extract fraction, Uremic encephalopathy",
author = "Gang Zheng and Jiqiu Wen and Hanzhang Lu and Yaxian Lou and Zhiying Pan and Wei Liu and Hui Liu and Xue Li and Zhe Zhang and Huijuan Chen and Xiang Kong and Song Luo and Xiaolu Jiang and Ya Liu and Zongjun Zhang and Zhang, {Long Jiang} and Lu, {Guang Ming}",
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TY - JOUR

T1 - Elevated global cerebral blood flow, oxygen extraction fraction and unchanged metabolic rate of oxygen in young adults with end-stage renal disease

T2 - an MRI study

AU - Zheng, Gang

AU - Wen, Jiqiu

AU - Lu, Hanzhang

AU - Lou, Yaxian

AU - Pan, Zhiying

AU - Liu, Wei

AU - Liu, Hui

AU - Li, Xue

AU - Zhang, Zhe

AU - Chen, Huijuan

AU - Kong, Xiang

AU - Luo, Song

AU - Jiang, Xiaolu

AU - Liu, Ya

AU - Zhang, Zongjun

AU - Zhang, Long Jiang

AU - Lu, Guang Ming

PY - 2015/9/3

Y1 - 2015/9/3

N2 - Objectives: To noninvasively assess global cerebral blood flow (CBF), oxygen extraction fraction (OEF) and cerebral metabolic rate of oxygen (CMRO2) in young adults with end-stage renal disease (ESRD). Methods: Thirty-six patients and 38 healthy volunteers were included and took part in MR examinations, blood and neuropsychological tests. CBF and OEF were measured by phase-contrast and T2-relaxation-under-spin-tagging MRI techniques, respectively. CMRO2 was computed from CBF, OEF and hematocrit according to Fick’s principle. Correlations were performed between MR measurements, blood biochemistry measurements and neuropsychological test scores. Results: Compared with controls, ESRD patients had elevated CBF (72.9 ± 12.5 vs. 63.8 ± 8.5 ml min−1 100 g−1, P < 0.001), elevated OEF (47.2 ± 10.2 vs. 35.8 ± 5.4 %, P < 0.001), but unaffected CMRO2 (199.5 ± 36.4 vs. 193.8 ± 28.6 μmol O2 min−1 100 g−1, P = 0.879). Hematocrit negatively correlated with CBF (r = −0.640, P < 0.001) and OEF (r = −0.701, P < 0.001), but not with CMRO2. Altered neuropsychological test scores of ESRD patients were associated with OEF and CBF, but not with CMRO2. There were weak relationships between eGFR and hematocrit (r = 0.308, P = 0.068) or CBF (r = 0.318, P = 0.059). Conclusion: Our findings suggested that anaemic young adults with ESRD may afford higher CBF and OEF to maintain a normal CMRO2. Despite this compensatory process, however, cognitive function was still impaired and its severity was correlated with their CBF and OEF abnormality. Key Points: • Anaemic young adults with ESRD may afford higher CBF and OEF.• Anaemic young adults with ESRD maintain a normal CMRO2.• Cognitive function was still impaired in young ESRD adults.• The severity of cognitive dysfunction correlated with CBF and OEF changes.

AB - Objectives: To noninvasively assess global cerebral blood flow (CBF), oxygen extraction fraction (OEF) and cerebral metabolic rate of oxygen (CMRO2) in young adults with end-stage renal disease (ESRD). Methods: Thirty-six patients and 38 healthy volunteers were included and took part in MR examinations, blood and neuropsychological tests. CBF and OEF were measured by phase-contrast and T2-relaxation-under-spin-tagging MRI techniques, respectively. CMRO2 was computed from CBF, OEF and hematocrit according to Fick’s principle. Correlations were performed between MR measurements, blood biochemistry measurements and neuropsychological test scores. Results: Compared with controls, ESRD patients had elevated CBF (72.9 ± 12.5 vs. 63.8 ± 8.5 ml min−1 100 g−1, P < 0.001), elevated OEF (47.2 ± 10.2 vs. 35.8 ± 5.4 %, P < 0.001), but unaffected CMRO2 (199.5 ± 36.4 vs. 193.8 ± 28.6 μmol O2 min−1 100 g−1, P = 0.879). Hematocrit negatively correlated with CBF (r = −0.640, P < 0.001) and OEF (r = −0.701, P < 0.001), but not with CMRO2. Altered neuropsychological test scores of ESRD patients were associated with OEF and CBF, but not with CMRO2. There were weak relationships between eGFR and hematocrit (r = 0.308, P = 0.068) or CBF (r = 0.318, P = 0.059). Conclusion: Our findings suggested that anaemic young adults with ESRD may afford higher CBF and OEF to maintain a normal CMRO2. Despite this compensatory process, however, cognitive function was still impaired and its severity was correlated with their CBF and OEF abnormality. Key Points: • Anaemic young adults with ESRD may afford higher CBF and OEF.• Anaemic young adults with ESRD maintain a normal CMRO2.• Cognitive function was still impaired in young ESRD adults.• The severity of cognitive dysfunction correlated with CBF and OEF changes.

KW - Cerebral blood flow

KW - Cerebral metabolic rate of oxygen

KW - End-stage renal disease

KW - Oxygen extract fraction

KW - Uremic encephalopathy

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